Systematic review of hearing loss after traumatic brain injury without associated temporal bone fracture

Background : Blunt head trauma without any temporal bone fracture or longitudinal temporal bone fracture, with an associated fracture of the labyrinth may cause labyrinthine injury with hearing loss and vertigo because of a concusive injury to the membranous labyrinth. Objective : To explain a case of labyrinthine concussion in patient with post traumatic brain injury experienced in Dr. Sardjito Hospital Yogyakarta. Case Description : A patient who treated in the hospital with spinning sensation after crush injury. She also had fracture of the left collum femur. Head CT scan and laboratory examination was initiated within normal limit. Patient then diagnosed with labyrinthine concussion and treated with symptomatic therapy and physiotherapy. Conclusion : Labyrinthine concussion can occur to the patient of blunt head trauma. Pharmacotherapy and physiotherapy should be initiated to reduce symptomps and uncomfortable sensation. Keywords : labyrinthine concussion, traumatic brain injury, mixed type vertigo

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Perilymphatic fistula and pneumolabyrinth without temporal bone fracture: a rare entity

BMJ Case Reports ◽

10.1136/bcr-2018-228457 ◽

2019 ◽

Vol 12 (3) ◽

pp. e228457 ◽

Cited By ~ 1

Author(s):

Ana Sousa Menezes ◽

Daniela Ribeiro ◽

Daniel Alves Miranda ◽

Sara Martins Pereira

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Temporal Bone ◽

Bone Fracture ◽

Round Window ◽

Sensorineural Hearing ◽

Temporal Bone Fracture ◽

Perilymphatic Fistula ◽

Hearing Thresholds ◽

Post Traumatic

Post-traumatic pneumolabyrinth is an uncommon clinical entity, particularly in the absence of temporal bone fracture. We report the case of a patient who presented to our emergency department with a headache, sudden left hearing loss and severe dizziness which began after a traumatic brain injury 3 days earlier. On examination, the patient presented signs of left vestibulopathy, left sensorineural hearing loss and positive fistula test, normal otoscopy and without focal neurological signs. The audiometry confirmed profound left sensorineural hearing loss. Cranial CT revealed a right occipital bone fracture and left frontal subdural haematoma, without signs of temporal bone fracture. Temporal bone high-resolution CT scan revealed left pneumolabyrinth affecting the vestibule and cochlea. Exploratory tympanotomy revealed perilymphatic fistula at the location of the round window. The sealing of defect was performed using lobule fat and fibrin glue. He presented complete resolution of the vestibular complaints, though the hearing thresholds remained stable.

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Contralateral sensorineural deafness in the absence of temporal bone fractures: an ignored entity in traumatic brain injury

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212134 ◽

2021 ◽

Vol 7 (6) ◽

pp. 1055

Author(s):

Marie Christy Sharafine Stephen ◽

Anju Venugopalan ◽

Nagaraj Bangalore Thimmasettaiah

Keyword(s):

Traumatic Brain Injury ◽

Hearing Loss ◽

Brain Injury ◽

Temporal Bone ◽

Bone Fractures ◽

Sensorineural Deafness ◽

Contralateral Side ◽

Profound Deafness ◽

Two Wheeler ◽

The Brain

Traumatic brain injury (TBI) associated with temporal bone fractures causing ipsilateral hearing loss is not uncommon. But contralateral sensorineural hearing loss (SNHL) in the absence of temporal bone fractures is not frequently encountered or looked for in TBI patients. A simple bed side tuning fork test followed by a formal audiogram underscore the importance of pre-emptive assessment to prevent a permanent handicap. We report a case of a young man with no prior ear disease or comorbidities, who sustained traumatic brain injury with right parieto-temporal hemorrhagic contusion and cervical myelopathy following a two-wheeler fall. Although, there was no evidence of temporal bone fractures, he developed sudden profound deafness on the contralateral side of the brain injury. Evaluation and treatment for the same were initially delayed as the management solely focused on his neurological complaints and as the hearing loss was contralateral it was perceived to be unrelated to his brain injury. We want to highlight the importance of thorough evaluation and screening for bilateral hearing loss in patients with TBI irrespective of the presence or absence of temporal bone fractures to initiate appropriate management. We also want to add our patient to the very few such cases reported in the literature. We analyzed these cases and reviewed the possible pathophysiological mechanisms behind this entity.

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Progressive Hearing Loss After Transverse Temporal Bone Fracture

Archives of Otolaryngology - Head and Neck Surgery ◽

10.1001/archotol.1995.01890070081017 ◽

1995 ◽

Vol 121 (7) ◽

pp. 795-799 ◽

Cited By ~ 37

Author(s):

A. T. Lyos ◽

M. A. Marsh ◽

H. A. Jenkins ◽

N. J. Coker

Keyword(s):

Hearing Loss ◽

Temporal Bone ◽

Bone Fracture ◽

Progressive Hearing Loss ◽

Temporal Bone Fracture

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Traumatic Labyrinthine Concussion in a Patient with Sensorineural Hearing Loss

The Neuroradiology Journal ◽

10.1177/197140091302600109 ◽

2013 ◽

Vol 26 (1) ◽

pp. 52-55 ◽

Cited By ~ 9

Author(s):

R. Chiaramonte ◽

M. Bonfiglio ◽

A. D'Amore ◽

A. Viglianesi ◽

T. Cavallaro ◽

...

Keyword(s):

Hearing Loss ◽

Magnetic Resonance ◽

Temporal Bone ◽

Bone Fracture ◽

Membranous Labyrinth ◽

Temporal Bone Fracture ◽

Perilymphatic Fistula ◽

Blunt Head Trauma ◽

Sensory Neural ◽

Sensory Neural Hearing Loss

Blunt head trauma without any temporal bone fracture or longitudinal temporal bone fracture, with an associated fracture of the labyrinth may cause labyrinthine injury with sensor neural hearing loss and vertigo because of a concussive injury to the membranous labyrinth. Sudden sensory neural hearing loss is relatively frequent. In most cases, the etiology is not discovered. One of the possible causes for sudden deafness is inner labyrinth bleeding or concussion, which were difficult to diagnose before the advent of magnetic resonance imaging. Vertigo without a demonstrable fracture may also be the result of labyrinthine concussion, cupololithiasis and perilymphatic fistula. We describe the clinical case of a patient with acute traumatic hearing loss and vertigo, without skull base fracture detected on computed tomography. Magnetic resonance study was also performed. We have integrated the discussion with features that allow the differential diagnosis from other similar conditions.

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Complete Restored Hearing Loss after Excessive Nose Blowing with Various CT Findings

Korean Journal of Otorhinolaryngology - Head and Neck Surgery ◽

10.3342/kjorl-hns.2020.00605 ◽

2020 ◽

Vol 63 (12) ◽

pp. 620-624

Author(s):

Ji Hoon Koh ◽

Eun Jung Lee

Keyword(s):

Hearing Loss ◽

Temporal Bone ◽

Middle Ear ◽

Bone Fracture ◽

Valsalva Maneuver ◽

Pressure Change ◽

Temporal Bone Fracture ◽

Perilymphatic Fistula ◽

Ct Findings ◽

Air Pockets

A perilymphatic fistula (PLF) is defined as leakage of perilymph with several possible causes such as superior canal dehiscence through trauma, temporal bone fracture, or sudden pressure change (e.g., skydiving or scuba diving). Pneumolabyrinth can result from temporal bone fracture after trauma, or sudden pressure change in the middle ear or cerebrospinal fluid, such as excessive nose blowing or Valsalva maneuver. A PLF and pneumolabyrinth may occur without trauma, associated with a sudden pressure change in the middle ear. We report two cases of PLF followed by pneumolabyrinth and one case of suspicious PLF without pneumolabyrinth after excessive nose blowing. All three cases were diagnosed as having sensorineural hearing loss and the patients recovered completely after conservative treatment. We report various CT findings of pneumolabyrinth and PLF, from normal CT findings to air pockets in the labyrinth and soft tissue density around the stapes.

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Hearing loss following temporal bone fractures- a study on classification of fractures and the prognosis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20171193 ◽

2017 ◽

Vol 3 (2) ◽

pp. 390

Author(s):

Nagaraj Maradi ◽

Somanath B. M.

Keyword(s):

Hearing Loss ◽

Temporal Bone ◽

Bone Fracture ◽

Bone Fractures ◽

Tertiary Care ◽

Classification Systems ◽

Otic Capsule ◽

Care Hospital ◽

Temporal Bone Fracture ◽

Traditional System

Background: Temporal bone fractures are traditionally classified as transverse, longitudinal or mixed fractures depending on their relationship to the petrous pyramid. However recent studies show that classifying temporal bone fractures as otic capsule sparing (OCS) and otic capsule violating (OCV) types has more relevance with the prognosis of hearing loss and other associated complications. To assess the predictive value of two different types of temporal bone fracture classification systems with respect to hearing loss and its type.Methods: This prospective study was done on patients attending a tertiary care hospital in the study period of one year. Temporal bone fracture patients satisfying inclusion and exclusion criteria were clinically and audiologically evaluated. All patients with temporal bone fractures were categorized into two groups - Longitudinal/ Transverse (old) and OCS / OCV (new). Hearing loss was evaluated audiologically on multiple intervals- initially following the injury once the patient is stable, later after a gap of 1 month and 3 months following the injury. Results: During the study period, 45 patients presenting with temporal bone fractures who satisfied the selection criteria were evaluated. The correlation was statistically significant for new classification system (P- 0.000) with respect to severity and prognosis of hearing loss which was not the case with the old system (P- 0.450). Conclusions: We found that classifying temporal bone fractures into OCV and OCS correlates well with the severity of the hearing loss, the prognosis of the patient and the residual hearing disability when compared to the traditional system.

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